Teenage Cyclocross Champion Died in Sleep After Heart Attack

Several “silent” heart attacks likely led to last year’s death of 15-year-old UK racer Charlie Craig

A young cyclocross racer who died suddenly last year appears to have suffered a massive heart attack brought on by a series of other, so-called “silent” heart attacks during training, according to an inquest this week.

Charlie Craig, a 15-year-old UK national champion, died in his sleep in January 2017. The son of former British cyclocross champion Nick Craig, he had been riding as part of British Cycling's Rider Route, a foundation that helps develop Olympic cyclists.

Craig seems to have damaged his heart while undergoing intense training. Sanjay Sharma, a cardiologist for the English Institute of Sport, told the coroner's court that he believes the young rider suffered a series of small, unnoticeable heart attacks over a prolonged period of time, brought on by “high surges of adrenaline” that left his heart scarred and vulnerable.

Though we tend to think of heart attacks as obvious—say, crushing chest pain and shortness of breath—they can occur completely under the radar as “silent” heart attacks, or silent ischemia (lack of oxygen) to the heart muscle. Silent heart attacks raise your risk for future heart attacks and heart failure.

These silent episodes are more common in older adults and risk factors are the same as for other cardiac events: smoking, diabetes, lack of exercise, overweight, and uncontrolled high blood pressure are all culprits. Research shows they're far more common than previously believed, with about 45 percent of all heart attacks being clinically silent.

Heart attacks, silent or otherwise, are not common in young athletes. But they do happen, often because of underlying congenital conditions. Sharma told that court that sudden cardiac events cause the death of fewer than 600 people under age 35 each year, noting that there was no evidence that Craig's heart condition was congenital, according to news reports.

Per Cycling Weekly, the coroner was told that Charlie and his older brother Tom, also an elite Team GB cyclist, had been sent to the hospital in 2015 for cardio evaluation after their father was found to have a heart abnormality of his own. Tom had been given an ECG, but Charlie had been deferred until he was older.

As is often the case following the deaths of young athletes, there's been a slew of sensational headlines regarding Craig and how he “pushed himself to a heart attack” pursuing his Olympic dreams. It’s something cardiologist Larry Creswell, a triathlon enthusiast, heart surgeon, and author of the Athlete’s Heart Blog, cautions against, while also stressing that we do need to take the possibility of hidden heart disease seriously in athletes of all ages.

“In general, the human body has built-in safeguards against ‘pushing oneself to death’ in exercise,” Creswell tells Bicycling. “But various inherited and acquired heart diseases can be a setup to have a fatal arrhythmia.” He says physical exams required in basically all school-based sports programs ought to catch this condition, but that serious heart problems can and do occasionally slip by doctors.

It's impossible to say for sure whether any additional screenings would have saved Craig, but it's likely that he just got tragically, tragically unlucky.

Never ignore heart symptoms you do notice, no matter how young, fit, and otherwise healthy you may be. “Exercise helps strengthen your heart and is good for cardiovascular health,” Creswell says, "but it does not make you immune to heart problems.”

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